Individual
IFEOMA IKWUANUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 BOYLSTON ST, BOSTON, MA 02199-1900
(508) 979-5557
Mailing address
46 FERNANDEZ CIR, RANDOLPH, MA 02368-4906
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2346110
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2346110
MA
Other
Enumeration date
01/31/2024
Last updated
09/21/2025
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